This section provides background information related to the present disclosure which is not necessarily prior art.
Image-guided biopsy, which is an interventional procedure minimizing damage to surrounding normal healthy tissue and sampling for pathological diagnosis of neoplastic diseases, has found broad applications in sites including retroperitoneum of adrenal glands, pancreas, lymphatic glands or the like, lung mediastinum, spine, appendicular bones, etc. Image-guided biopsy enables detailed, three-dimensional localization of a lesion site using high-resolution medical images, and a visible biopsy needle entered a tissue facilitates the detection of small-sized lesions.
In a surgery site where image-guided biopsy is performed, an insertion trajectory of a biopsy needle can be guided by CT or C-arm fluoroscopy images. Due to the radiation exposure risks, however, it is customary to plan out the insertion trajectory beforehand from diagnostic images. For instance, an entry angle of the biopsy needle entering the body of a patient is important for planning an insertion trajectory, and the insertion trajectory is then planned after the entry angle and the entry point are determined. Meanwhile, this insertion trajectory plan is heavily dependent on experiences of the surgeon, rather than the objective bases on a degree of invasion into a vessel or bone. As such, each surgeon may select a different optimal insertion trajectory for a biopsy of the same lesion. In particular, for a lung biopsy using fluoroscopy, it is customary to select a shortest insertion trajectory from an axial 2D image. In a real surgery site, however, there is a big risk of hemorrhage or bleeding which often occurs during a biopsy procedure.
Advances in medical imaging technologies, in particular, X-RAY CT imaging make it possible to observe millimeter or smaller-sized microstructures in vivo. Technologies involved in spatial resolution as well as temporal resolution of images have also been developed over a short period of time. Nevertheless, a challenge still remains for finding an insertion trajectory without interfering with pulmonary vessels, mainly due to complicated morphology of the pulmonary vessels, e.g. a high density of the vessel distribution, close intersections, or the presence of other neighboring vessels running side by side. Therefore, it is necessary to provide more objective and quantitative bases on a degree of invasion into a vessel caused by an intended insertion trajectory as well as a distance of the insertion trajectory. Also, it would be very convenient and make great contributions to an increased safety level of surgery if there is a way to automatically generate a three-dimensional, minimally invasive and shortest insertion trajectory.
U.S. Pat. No. 6,487,431 discloses a technology of displaying multiple CT image slices in real time on a display monitor to guide a biopsy needle along the guideline indicated. However, this document does not present a method for objectively and quantitatively evaluating a degree of invasion by the guide line (insertion trajectory) itself for connecting an entry point to a target, and whether the guideline is indeed an optimal inversion trajectory.
When a medical device including a lead for deep brain stimulation, a biopsy needle, a probe or a catheter for example is inserted or implanted into an internal part of the body, such as, lung, brain or liver, it is crucial that none of vessels or important anatomical structures should be damaged or they should minimally invaded.
A brain surgery, for example, includes all neurosurgical operations that affect different functions of the brain. These neurosurgical operations cover not only tumor removal operations, but also deep brain stimulation (DBS) for stimulating a certain region in the brain that has a specific function. For instance, a neurosurgeon will perform DBS to treat serious diseases like Parkinson's disease, obsessive compulsive disorder and depression. In DBS, an electrode capable of suppressing or stimulating some portions of cerebral nerves needs to be implanted in a deep part of the brain in order to bring brain functions of a patient back to normal levels. The electrode may be arranged at the end of a lead, and the lead is then inserted along an insertion trajectory in the brain.
During the insertion of a medical device or during implantation, it is important to find an insertion trajectory for a lead, which would not damage any major structure including the cerebrovascular system, while bring a surgical tool such as a DBS electrode to a target in a very precise manner. An entry angle of the lead into the brain is a principle factor for planning an insertion trajectory. Once an entry angle and an entry point are determined, an insertion trajectory may be generated. In reality, however, a conventional insertion trajectory plan is heavily dependent on experiences of the surgeon, rather than the objective and quantitative bases on a degree of invasion into a vessel or an important anatomical structure of the brain. As such, even for the same patient, surgeons will probably find different insertion trajectories. U.S. Pat. Application No. 2012/0184844 discloses a method for generating multiple insertion trajectories in DBS, but still any specific method for evaluating a degree of invasion in a given insertion trajectory itself and for planning an insertion trajectory without interfering with vessels is not mentioned here.
For an interventional procedure where a medical device including a lead for deep brain stimulation, a biopsy needle, a probe or a catheter for example is inserted or implanted into an internal part of the body, such as, lung, brain or liver, it is important that the interventional procedure is performed without damaging vessels, or in a minimally invasive manner.
Image-guided biopsy, which is one of interventional procedures minimizing damage to surrounding normal healthy tissue and sampling for pathological diagnosis of neoplastic diseases, has found broad applications in sites including retroperitoneum of adrenal glands, pancreas, lymphatic glands or the like, lung mediastinum, spine, appendicular bones, etc.
Among interventional procedures including needle insertion as in a biopsy, minimally invasive surgery has been rapidly growing. Such an image-guided biopsy uses an insertion trajectory that is planned out beforehand from diagnostic images, due to the radiation exposure risks. However, in a surgery site, an insertion trajectory of a biopsy needle is still guided by CT or C-arm fluoroscopy images, and an insertion trajectory is still searched out by experienced surgeons who should perform a surgical operation under radiation exposure. Therefore, there is a need to develop a robot for interventional procedures including needle insertion, so as to resolve the radiation exposure risks of operators or surgeons as well as patients and to promote the accuracy of a surgical operation. The use of a robot for interventional procedures including needle insertion is expected to save time for a surgical operation, thereby reducing the radiation exposure of a patient, to reduce complications in a patient, and to maximize safety. Further, it is possible to get rid of the radiation exposure risks of a surgeon, and the surgeon can benefit from improved safety through such an automated system.
This interventional procedure like inserting a needle is typically performed as follows: the robot for an interventional procedure is set up, a biopsy needle is installed in the robot, the robot automatically moves and takes its place in an initial position in response to an external control signal, and the biopsy needle is then shifted right in front of an entry point on the skin of a patient.
In the meantime, some patients get afraid or feel inconvenient of using the biopsy needle. Moreover, an operator or assistant nearby may get stung by the biopsy needle and become infected, or the biopsy needle can collide with other equipment and become infected itself.
U.S. Pat. Application No. 2012/0330325 discloses a robot equipped with a biopsy needle which is being exposed as is. The document has neither acknowledged the problems thereof, nor suggested or implied any way to resolve the problems.